Best practices legislation moving forward in Minnesota
■ The competing bills raise familiar concern over government intrusion into medicine.
By Andis Robeznieks — Posted May 3, 2004
The two houses of the Minnesota Legislature have passed different bills on the same subject: best practices guidelines for physicians. Now the health care community is watching intently to see what emerges from a conference committee.
The Minnesota Medical Assn. supports the House bill, which calls for the promotion of physician-designed best practices, and it opposes the Senate version, which calls for withholding payments to doctors who don't comply with guidelines.
"This is not legislation we initiated or that we wanted ... but we are trying to take a position to champion quality of care," said MMA CEO Robert K. Meiches, MD. "It needs to be physician-determined and physician-led."
A health care activist group is trying to rally physicians to oppose both bills. Twila Brase, a registered nurse and president of the Citizens' Council on Health Care, said public reporting of compliance will force doctors to conform even if guidelines aren't mandated. "No doctor is going to want to be on a state report that says 'Dr. Jones follows best practices 20% of the time,' " she said. "Maybe Dr. Jones has interesting patients who don't fit neatly into the government's boxes, but the public is going to look at that and say: 'That's a bad doctor.' "
Dr. Meiches, a Minneapolis internist specializing in geriatrics, said promoting the use of physician-determined best practices does not have to mean one-size-fits-all health care.
"These are things that are good for most patients and that most doctors should use, but you still have to individualize care," he said.